ABSTRACT
Gallbladder-duodenal (cholecystoduodenal) fistula is an uncommon bilioenteric fistula between the gallbladder and the duodenum. It usually occurs following a chronic case of cholecystitis upon which the gallbladder adheres to the adjacent duodenum, and a stone penetrates through the wall. The case presented herein is that of a gallbladder-duodenal fistula detected primarily with the use of ultrasound imaging, and subsequently confirmed by computed tomography. The patient is a 54-year-old woman who was admitted with upper abdominal pain. The fistula was caused by chronic cholecystitis, however no gallstones were present in the duodenum. Surgical management was undertaken for the patient, and the recovery was uneventful.
ABSTRACT
Poly(lactide-co-glycolic acid) (PLGA) and poly(L-lactide) (PLLA) films are widely studied for various biomedical applications. Because of their use for drug delivery, achieving controlled release from these biodegradable films has become an area of intense research. The objective of this study is therefore to investigate how PLGA and PLLA films fabricated through an irradiated-multi-layer approach can be a viable technique to achieve controlled drug delivery. In this study, lidocaine base (lido-base) and lidocaine salt (lido-salt) were used as model hydrophobic and hydrophilic drugs, respectively. Results show that multi-layer PLGA underwent pseudo surface degradation, while multi-layer PLLA degraded to a lesser extent over the same study period. Triphasic release was observed for lido-base, whereas lido-salt was released through a biphasic profile, from both polymer systems. The two dominating release phases for both drugs were diffusion and zero-order release, where the latter is characterized by the onset of mass loss. It was shown that PLGA had a shorter diffusion phase and a longer zero-order phase, while the contrary was true for PLLA. This difference was due to the faster degradation for PLGA. In conclusion, the hydrophilic gradient induced from an irradiated-multi-layer film system shows potential for controlled and sustained release of drugs.
